ReimbursementQuestion 80 of 100
A patient owes a $40 copay and has 20% coinsurance on an allowed amount of $250 after the copay does not apply to coinsurance. If the deductible is already met, what does the payer pay on the $250 allowed amount (coinsurance portion only)?
a.$50, which is the coinsurance owed by the patient
b.$200, which is 80% of the $250 allowed amount
c.$250, the full allowed amount
d.$40, the copay
Explanation
When the deductible is met and coinsurance is 20%, the patient pays 20% of the allowed amount and the payer pays the remaining 80%. Eighty percent of $250 is $200, which is the payer's share of the coinsurance calculation. The $50 balance is the patient's coinsurance responsibility.
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